The National HHVBP Begins in 6 Months: Are You Prepared? (100 Minutes)
Description: The Center for Medicare & Medicaid Services (CMS) is expanding the Home Health Value-Based Purchasing Model (HHVBP) nationally effective January 2023. Agencies have another 18 months to prepare and taking an inventory of where you stand is important. Creating your internal teams to set goals and monitor your performance will help ensure your organization is ready. Understanding the mechanics of the TPS calculation and what-if scenarios is also an important step.
- Identify the key components to HHVBP that should be tracked.
- Assess and evaluate how changes in individual scores may impact the your overall TPS.
- Share examples of how your organization should be tracking and managing your performance.
Recruitment and Retention: Strategies to Overcome Staffing Challenges (100 minutes)
Description: The biggest challenge for Home Health and Hospice providers, now and well into the future, is dealing with workforce challenges. The key for maximizing the ROI is to focus on retention. This session will help guide your decision making around compensation, professional development, growth potential for staff and overall company culture, which all influences employee retention. There are winners and losers when it comes to talent – this session will offer the takeaways you need to ensure you are a winner!
- Understand the financial impact of staff turnover, specifically the effect on productivity and its impact on limiting growth and capacity.
- Learn how to create your own budget calculating the impact of turnover in all departments of your organization.
- Understand exactly what the industry benchmarks are for retaining staff, as well as important statistics related to talent acquisition and retention.
- Learn specific techniques to improve their organizations retention numbers including leadership development, building strong company culture, compensation strategies, and more.
Home Health Revenue – Understanding PDGM (100 Minutes)
Description: Fully understanding the Patient Driven Groupings Model (PDGM) and the influence of accurate clinical documentation practices is critical to achieving optimal quality reporting and revenue accuracy. Yet often there is a knowledge gap between clinicians and financial managers to measure the impact and understand the significance of everyday clinical documentation scenarios that drive quality reporting and financial results. This session will provide details behind the PDGM model and guide participants through methods of assessing performance using industry key performance indicators (KPIs). This session will also explore various clinical scenarios that drive quality and financial impact to deepen participants’ understanding of how to adopt best practices in documentation and process to drive resulting quality and financial performance.
- Enhance participants’ understanding of the PDGM model and related industry KPIs.
- Improve recognition of typical weaknesses in clinical documentation practices that result in poor quality reporting and financial accuracy.
- Apply methods for assessing documentation accuracy in relation to quality reporting and financial performance.
Home Health Revenue Cycle – (100 Minutes)
Description: Analysis of revenue cycle impact on your agency should begin at intake. The revenue cycle continues to be affected by new threats to cash flow and compliance and agencies must ensure that best practices are implemented within their agencies to protect revenue and cash flow. The transition to the Notice of Admission (NOA) for Medicare and Medicare Advantage directly impacts all aspects of revenue cycle operations and presents a new threat for revenue leakage. This session will take agencies through the ideal process from Intake through billing to assist agencies in identifying gaps that need to be filled.
- Describe the impact of the Notice of Admission (NOA) on the revenue cycle process and cash flow management.
- Define best practices for optimizing cash flow through effective processes from Intake through the billing process.
- Review benchmarks to measure revenue cycle performance.
PDGM Data Update Year 2: Lessons Learned (100 Minutes)
Description: Compounded by the effects of a global pandemic, assessing the trends and benchmarks of PDGM is more difficult but more necessary than ever. It is an important step to determine how your agency is performing under the PDGM model and handling the operational challenges of COVID-19. For CY 2022, we will discuss CMS’ stance on payment adjustments due to behavioral changes, a national roll-out of Value Based Purchasing models, and other PDGM refinements. What does the data show regarding behavioral changes compared to CMS’s original estimations, and what will we likely see in PDGM changes for CY 2023?
- Assess PDGM trends in the first two years under the PDGM prospective payment system.
- Describe how the continuing COVID-19 pandemic is impacting home health utilization, referral statistics and overall fiscal and operational performance under PDGM.
- Identify how behavioral changes. the Final Rule for CY 2022, and the expansion of a national Value Based Purchasing model may impact your agency.
Utilization Management Under PDGM (100 Minutes)
Description: In addition to the challenges with PDGM surrounding 30-day payment periods and updated visit thresholds, the industry also faced a variety of regulatory changes brought on by the COVID-19 pandemic. With telehealth becoming a widely used tool in home health, it also brought upon challenges in managing patient care. Data shows providers continue to struggle with managing utilization under PDGM. This heightens the focus on utilization management strategies and what your organization can do to achieve clinical excellence while remaining financially strong. This session will review national utilization trends and focus on best practices for managing utilization, while maintaining quality care delivery.
- Identify common utilization trends in both initial and subsequent 30-day periods.
- Review best practices for management of utilization across both 30-day billing periods.
- How to leverage EMR functionality and reporting for management of subsequent 30-day billing periods.
Using Analytics and Key Performance Indicators to Improve Hospice Operations (50 Minutes)
Description: As hospice agencies face continued regulatory and reimbursement changes, they are challenged to attain operational efficiency while performing within their budget and meeting quality standards. One way to manage performance is through analytics and key performance indicators (KPIs). When used effectively, these metrics can help hospices by highlighting strengths, identifying potential opportunities, and alerting them to areas for concern. With so many benchmarks available – from the Medicare publicly reported data, the PEPPER report, and industry specific operational benchmarks – it can be difficult to decipher which indicators are most critical for monitoring and improving hospice performance. This session will review the critical KPIs every hospice agency should be monitoring, explain how KPIs can be used to move the needle on performance, and help attendees understand the key clinical and operational metrics that drive financial success.
- Identify critical key performance indicators used to monitor clinical and financial performance.
- Learn how hospice analytics can be used to improve financial and operational performance.
- Understand how management of clinical and operational metrics can lead to improved financial results.
Choose Home Care Act: It’s Impact on Home Care Agencies (50 Minutes)
Description: The Choose Home Care Act, introduced in 2021 on a bipartisan basis in both the U.S. House and Senate, aims to increase access to care in the home following hospitalization for eligible Medicare beneficiaries by providing a post-acute option for nursing home level services at home. This Act represents significant changes and opportunities in the delivery of home care for agencies and their patients.
- Gain a greater understanding of the Act and its ramifications for home care agencies.
- Assess areas of impacts for your agency.
- Outline ideas to implement after returning to your agency.
Evaluating & Negotiating Payer Contracts (50 Minutes)
Description: With the growth of Medicare Advantage and the ongoing expansion of Medicaid coverage, often is provided through a Managed Medicaid program, continued success requires programs to have robust processes in place to ensure payment for services. This session will identify the key elements in contracting with these payers.
- Identify elements to payer contracts that will potentially impact collections.
- Establish guidelines for intake, operations, and revenue cycle departments to enable timely production of a claim.
- Construct financial modeling for determining whether to maintain contractual relationship.
Revenue Cycle – Hospice (100 Minutes)
Description: Effective management of the hospice revenue cycle is an ongoing challenge, as cash flow optimization efforts must always be balanced against potential compliance threats and the evolving hospice payment landscape. Office of Inspector General reports continue to suggest the possibility of increased scrutiny of the hospice benefit, which often comes in the form of increased program integrity activity, impacting the revenue cycle. Individual states continue to adopt Medicaid managed care, significantly complicating the hospice revenue cycle, and the hospice benefit continues to draw interest from program integrity contractors. The second year of the hospice benefit component of the Value-Based Insurance Design (VBID) Model offers new challenges in managing the revenue cycle, as more Medicare Advantage plans participate and expand the reach of this demonstration project. Resumption of the Medicare Targeted Probe and Educate (TPE) process increases the consequences of poor revenue cycle and documentation management practices.
- Assess the latest information related to the impact of VBID on the hospice revenue cycle.
- Identify best practices for optimizing cash flow and minimizing compliance risks through effective revenue cycle process management.
- Apply benchmarks to revenue cycle KPIs.
Evaluating Quality Outcomes and Star Ratings Across Home Health & Hospice (100 Minutes)
Description: CMS drives your quality assurance program initiatives by updating the QRP measures on a regular basis. Learn how CMS decides what to include or exclude in the Home Health and Hospice QRPs and how you should be tracking and managing your scores to be successful. Also, consider how palliative care adds a new dimension in how you determine what success is.
- Identify the latest updates and trends in HHVBP and Star Rating measure scores.
- Examine the clinical operational models and opportunities for improving HHVBP, Care Compare and Star Ratings scores.
- Share best practices in your operational and clinical programs that will improve your outcomes that will lead to financial success.
Crafting a Home Health Compensation System That Gives You Great Results (50 Minutes)
Description: The single biggest cost for home health agencies is your staff. Your staff is also your best sales force, the reason for your outcomes, and the engine of your business. Learn what other agencies are doing to keep staff happy and improve their outcomes, while maintaining a healthy bottom line.
- Identify home health pay structures that strike a balance between cost containment and performance management.
- Assess the effectiveness of compensation models in achieving patient outcomes, improving employee productivity, and protecting agency profit.
- Recognize the pros and cons of each pay structure to be able to determine which pay structure would work best for their organization and staff.
Medicare Advantage Coverage of Hospice Care: Opportunities, Risks and Insights (100 Minutes)
Description: Under the Medicare Advantage Value-Based Insurance Design (VBID), Hospice Benefit Component demonstration MA plans may – for the first time ever – include hospice care among their benefit offerings. The four-year demonstration program started in January 2021 and has grown in scope, but aspects of the model are changing over time, including the anticipated application of a new “network adequacy” standard beginning in 2023. This session will provide insights into key elements of the model, how in- and out-of-network hospices are variably impacted, describe various hospice providers’ experience under the model, and identify key considerations related to contracting with MA plans as an in-network hospice provider.
- Identify key elements of the MA-VBID Hospice Benefit Component Model, including additional benefits offered.
- Discuss changes to the model over the years in which it has operated, including the network adequacy standard.
- Outline how the model variably impacts in- and out-of-network hospice providers, including opportunities for these hospices.
- Identify key considerations for hospices in making decisions around potential contracting with MA plans as an in-network provider of services.
Creative Ways to Expand Your Workforce! (100 Minutes)
Description: Home-based care workforce capacity has reached a tipping point with the demands of COVID-19. Organizations have experienced a crisis that has led to increased in turnover, retirement, and burnout, while facing critical demand for care. New solutions must be developed to meet this demand.
The financial and operational components of working with internships, universities and training institutions will be explored during this session to develop a broader base of employees to meet the demands of the home health and hospice services industry.
- Define the current health care staffing shortage.
- Identify components of a program and practices to expand workforce.
- Outline the financial impact of developing programs to increase workforce capacity.
Getting Paid by Medicare Advantage Plans (50 Minutes)
Description: Medicare Advantage Organizations and all the plans they offer are continuing to add thousands of patients per year to their plans. The greatest challenge for home health agencies in dealing with Medicare Advantage is getting the claims paid, even when the agency has received an authorization from the plan. Challenges include, but are not limited to, lack of adequate authorization, out of network medical reviews, agencies not understanding the content of the contract and exactly what is required to get paid. Understanding the requirements for billing/payment supersede the rates that the contract promise to pay.
- Detail methods of evaluating the current process in your agency for securing MA authorizations and reauthorizations.
- Review the process of dealing with MA Plans when the agency is out of network.
- Evaluate statistics of timely filing and timely denial management.
Hospice Compensation Models (50 Minutes)
Description: This session will review the various compensation models used by hospice agencies. Some to be discussed are hourly, salaried, per visit, and incentive bonus pay. How do these effect the agency financially, the managers, and field staff? How the compensation model impacts staff satisfaction and quality will also be discussed.
- Evaluate the various compensation models in hospice and their effect on employee satisfaction.
- How does compensation impact employee satisfaction/engagement and quality scores?
- What is the impact of the various compensation models on the agency financial statements and quality scores?
Utilizing New Technologies to Automate and Transform Your Company (50 Minutes)
Description: Medicine is changing rapidly, and the agencies able to do more with less will be able to grow and improve their margins and outcomes. Learn what technologies are transforming home health and hospice, including artificial intelligence, wearable tech, and process automation, and discover how to use these innovations to move your agency into the future.
- Identify workplace automation technologies that can transform your business and how to utilize them.
- Explain how to achieve a return on your organization’s investment in these technologies.
- Assess the technologies that will best fit your existing processes and provide the greatest impact to your organization.
The Relentless Pursuit of Perfection: Review Choice Demonstration Lessons Learned (50 Minutes)
Description: Review Choice Demonstration is here to stay. As RCD continues to expand, our knowledge of what it takes to achieve a successful affirmation improves. RCD will affect internal processes for all departments, particularly for the clinical and billing staff. Home Health operators will need to understand which benchmarks to monitor daily to prevent billing bottlenecks in their organization. Learn from top-performing home health agencies on the strategies, processes, staff education, and documentation you need to succeed and thrive when it’s your turn to participate in RCD.
- Identify required documentation and learn documentation tips and tricks to help ensure affirmation.
- Eliminate costly and time-consuming bottlenecks.
- Learn what benchmarks to measure to ensure timely affirmations and avoid RCD and billing backlogs.
Program Integrity Audits – RACs, UPICs, and SMRCs (50 Minutes)
Description: Home health and hospice agencies continue to be targeted for compliance-related issues from multiple program integrity contractors. This scrutiny often takes the form of post-pay audits by Recovery Audit Contractors (RACs), Unified Program Integrity Contractors (UPICs), and Supplemental Medical Review Contractors (SMRCs) that can result in massive penalties computed on extrapolated error rates, suspended payments, or other extreme measures. This session will examine the most common threats from program integrity contractors and offer insights into typical contractor behaviors. In addition, this session will also address practices your agency can implement to assess your risk and prepare for such audits.
- Outline key details from current results of audit initiatives and recent program integrity contractor activity and actions.
- Identify strategies for successfully managing claims audits by contractors.
- Describe effective compliance risk assessment and mitigation procedures.
- Discuss practices your agency can implement to assess risk and prepare for these types of audits.
Diversifying Service Lines (50 Minutes)
Description: Home care market transformation is rapidly impacting how services are funded, the scope of services provided in the home, the complexity of patients being cared for in the home, and the expectations to improve health and cost outcomes. Diversifying service line offerings could be a valuable tool to strategically position providers to meet these market demands. This session will benefit organizational leaders with an understanding of the strategic, financial and outcomes benefits of a range of complementary home care products such as private duty, hospice, behavioral health, care management, visiting physicians and personal care.
- Outline strategic planning factors impacting home care providers.
- Identify a range of opportunities to expand traditional home care offerings or venture into new service line offerings.
- Assess the relative benefit of each from a strategic, financial, and quality outcomes perspective.
- Discuss critical success factors which might determine best organization fit.
Home Health Compliance: Helping Clinical Understand Financial Risks (50 Minutes)
Description: Clinical work has an enormous impact on not only quality of care, but the financial performance of an agency. Whether they fulfill an administrative or clinical role, the need for financial education and understanding has become an inescapable reality. Not only do clinical leaders already impact the financial health of an agency based on clinical decisions, but they will expand this role with the advent of nation-wide Value Based Purchasing. There is an ever-increasing need for financially informed decision-makers at every level. Though most clinical leaders understand the importance of improving financial performance, few understand how they directly impact the financial condition of the agency through their everyday decisions. This is no more evident than in the process of undergoing any type of audit with a financial risk associated with it. These include Targeted Probe & Edit (TPE), Additional Documentation Requests (ADRs), and a variety of other acronym led auditing entities such as MACs, ZPICS, RACs, etc. This session is designed to help clinical leaders learn how their daily decisions are linked to audit results and the associated financial risks.
- Identify the types of audits that home health agencies are subject to, explain the potential financial impact of negative audit results, and how clinical leadership is linked to the audit process.
- Explain the financial impact of everyday clinical decisions and how the affect financial audit risks.
- Identify how clinical leaders can help minimize risk and financial impact of audits.
Compliance Related Financial Risks – Hospice (50 Minutes)
Description: CMS has increased funding for and initiated policies that support combatting fraud, waste, and abuse and reformed the hospice survey process. The Targeted Probe and Educate (TPE) initiative resumed in fall 2021, with all Medicare Administrative Contractors (MACs) having at least one hospice TPE topic. There have been several hospice-specific projects undertaken by the Supplemental Medical Review Contractor (SMRC) and there has been significant audit activity from the Unified Program Integrity Contractors (UPICs). Additionally, hospice survey reforms have introduced enforcement remedies, thereby increasing financial risks of non-compliance with the conditions of participation. This session will cover the financial risks associated with each of these types of audits and the new enforcement remedies, advise regarding how to develop a timely and strong response, and provide suggestions for mitigating risks.
- Explain most frequent audit types and associated financial risks.
- Explain survey enforcement remedies and associated financial risks.
- Discuss actions to mitigate risks.
- List and discuss steps for developing a timely and strong response to ADRs.
Developing Talent Within: Mentoring Middle-Management to the C-Suite (50 Minutes)
Description: Talent is one of an organization’s most valuable assets. Filling C-Suite roles from within the organization provides smooth transition of management and extension of company values and culture. Achievement of internal promotion into CEO, CFO and COO roles requires a strong intentional mentoring and leadership plan to give aspiring managers the opportunities to develop necessary executive skills. Over the past year, nearly 30 million Baby Boomers retired, making it more important than ever to develop a strong succession plan for organizational leadership.
- Discuss benefits and obstacles to internal and external c-suite candidates.
- Describe development and implementation of an internal leadership development plan.
- Describe steps leaders seeking career advancement can take to achieve skills and talent needed to successfully transition into C-Suite roles.
Turning Vision into Value: Top 3 Business Opportunities for Private Duty Agencies (50 Minutes)
Description: Older Americans with chronic illness and other maladies of aging insist on remaining as independent as possible and aging in place. This presents the Private Duty arena with enormous opportunities. How can Private Duty agencies set themselves apart? What innovations have you yet to capitalize on? Industry experts will discuss several opportunities that your organization can take advantage of to serve your communities better while also increasing the value of your organization and having meaningful positive impacts on your bottom line. This session will touch on the top three business opportunities for Private Duty agencies and help your organization become a trailblazer.
- Explain current trends and opportunities shaping the environment for private duty care.
- Outline the pros and cons of innovation in the Private Duty arena.
- Learn expanded ways that Private Duty agencies can best serve and partner with other healthcare providers to maximize their potential.
Staffing Strategies in a Pandemic World and Beyond (50 Minutes)
Description: Staffing issues have become more prominent in the home-based services industry. Forward-thinking agencies are constantly seeking ways to recruit, lead, and retain a competent and satisfied workforce. As the industry moves beyond COVID-19, it is time to consider a strategy to not simply fill positions but look at business goals, meaningful work, and future opportunities.
- Analyze current workforce to prepare for patterns and potential gaps such as retirement, maternity/paternity leave and future promotions.
- Explore the potential of contract labor and the roles of specific disciplines with the flexibility of recent regulatory guidance.
- Apply telehealth strategies to manage patients while embracing the flexibility and remote opportunities possible for current and future staff.
Key Aspects of Successful Palliative Care Programs (100 Minutes)
Description: While palliative care has demonstrated value in achieving the Triple AIM, its financial viability for the program operator remains a challenge. This session will examine different models of palliative care, as well as key elements of a successful palliative care program with a special emphasis on tips for new start-ups as well as established programs.
- Outline different models of palliative care.
- Identify key aspects of a successful palliative care program.
- For each key aspect, enumerate tips applicable to starting a program and tips for established programs.
The Secrets Hidden in Your Financial Statements (100 Minutes)
Description: In evaluating mergers and acquisition opportunities, we tend to focus mostly on a prospect’s revenues and earnings, but there is so much more to glean from financial statements and other related reports. These clues can help solve the valuation riddle that relies upon income, growth, and risk. In this session, we discuss the hidden gems to look for, what they mean, and how they might impact a buyer’s and seller’s acquisition or divestiture decisions.
- Identify key line items in financial statements and related reports that reveal the strengths and weaknesses of a home health or hospice acquisition candidate.
- Interpret what they mean and how they directly, and indirectly, impact valuation.
- Consider and implement strategies to strengthen the attractiveness of an acquisition candidate.
Educating your Organization on the Financial Impact of Quality (50 Minutes)
Description: Managing quality is more than just improving patient care. Under HHVBP there is a direct connection to your agency’s financial health. CAHPS Star ratings and other Care Compare scores of your Home Health and Hospice organizations will influence which referrers and patients will use you. Tracking and educating your clinical and financial staff and managers on the relationship of quality to your financial success is critical.
- Review the Quality Review Programs (QRPs) and the relationships to your organization’s financial health.
- Demonstrate how tracking and sharing results is important part of your internal communications.
- Describe the best practices in sharing your data across your organization.
FMC 2022 Pre-Conferences
Home Health Summer Camp 2022
Description: A regular feature of the Financial Management Conference, industry rookies and veterans will benefit from the detailed understanding of the fundamental financial tools and operational strategies for developing and maintaining positive financial outcomes offered in the Summer Camp. This updated 2021 program is designed for beginner-to-intermediate level financial staff members who have some experience in home care financial management and who wish to expand their knowledge in the diverse world of home care finance.
- Current Medicare reimbursement issues faced by home health agencies.
- Essential benchmark data needed to manage a home health agency.
- How to integrate communications between financial and clinical staff.
- Using the Medicare cost report as a management resource tool.
- Medicare Advantage and Medicaid business impacts.
- Compliance responsibilities with payers and more.
- Establishing billing oversight processes.
- Undertaking a feasibility analysis for instituting new programs, expanding service areas, and creating branch offices.
Hospice Summer Camp 2022
Description: Getting back to the basics has never been more important, as hospice continues to grow and mature as a health care program. This preconference provides an updated and thorough overview of the financial aspects of hospice, including discussion of emerging national economic and policy changes which will impact hospice operations, regulatory issues, and revenue-enhancing strategies. Hospice Summer Camp 2021 is designed for Intermediate-Advanced hospice executives seeking to sharpen the skills and knowledge needed to improve management hospice financial operations in this changing environment.
- Financial accounting for all hospice services including bereavement, physician services, volunteers, therapies including music, massage, pet, liaisons or community representatives.
- Hospice Cost Reporting.
- Compliance best practices.
- Hospice staff compensation, strategies for improved productivity and case capacity.
- Palliative Care Services and impact on Hospice Services.
- General Inpatient Services, owned or leasing arrangements, respite and residential services.
- Hospice cap calculation updates – how to monitor during the year.